Restorative Dentistry

353 Pages·2008·10.64 MB·English

by  Peter Jacobsen

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Restorative Dentistry
i
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ToCharlotte,MatthewandChristopher–maytheirdreamscometrue.
ii
BLUK133-Jacobsen January5,2008 21:39
Restorative Dentistry
An Integrated Approach
Second Edition
Peter Jacobsen, MDS(Lond),FDSRCS(Eng),FHEA
ReaderinRestorativeDentistry,DivisionofAdultDentalHealth,
WalesCollegeofMedicine,CardiffUniversity,Cardiff,UK;
HonoraryConsultantinRestorativeDentistry,
CardiffandValeNHSTrust,Cardiff,UK
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BLUK133-Jacobsen January5,2008 21:39
(cid:2)C 2008byBlackwellPublishingLtd
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Firstpublished2008byBlackwellMunksgaard
ISBN:9781405167994
LibraryofCongressCataloging-in-PublicationData
Restorativedentistry:anintegratedapproach/PeterJacobsen.–2nded.
p. ; cm.
Includesbibliographicalreferencesandindex.
ISBN:978-1-4051-6799-4(pbk.:alk.paper)
1.Dentistry,Operative.
[DNLM:1.DentalRestoration,Permanent.WU300AR4352008] I.Jacobsen,P.H.(PeterH.)
RK501.R4732008
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2007032687
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Contents
Contributors vii 14 PrinciplesofOcclusalManagement 143
Preface ix
Acknowledgements xi 15 FixedProsthodontics–Crowns 157
16 ColourandAesthetics 175
SectionI ThePatient
17 ImpressionMaterialsandTechniques 187
1 ThePatient–HisLimitations
andExpectations 3
SectionIV FixedandRemovableProsthodontics
2 HistoryandExamination 5
18 DiagnosisandTreatmentPlanningfor
3 DiagnosisandStabilisation 15
FixedandRemovableProsthodontics 199
4 GeneralPrinciplesofTreatment
19 FixedProsthodontics:Resin-Retained
Planning 25
Bridgework 210
SectionII TheRestorationandItsEnvironment 20 FixedProsthodontics:Conventional
Bridgework–DesignandPlanning 217
5 AppliedBiologyoftheTeeth 35
21 FixedProsthodontics:Conventional
6 ThePathologyofCariesandPulpal Bridgework–ClinicalProcedures 226
Disorders 46
22 FixedProsthodontics:BasicPrinciples
7 ThePeriodontiuminHealthandDisease 56 ofImplants 240
8 FunctionalAnatomyoftheOcclusion 62 23 FixedProsthodontics:Clinical
AspectsofImplants 249
9 PropertiesofRestorativeMaterials 74
24 RemovableProsthodontics:Partial
Dentures–Design 263
SectionIII ClinicalManagementand
Techniques 25 RemovableProsthodontics:Partial
Dentures–ClinicalProcedures 273
10 IntracoronalRestorations 91
26 RemovableProsthodontics:Complete
11 ManagementoftheDeepCavity 107 Dentures 278
12 RootCanalTreatment 115
SectionV Problems
13 ManagementofthePeriodontally
InvolvedDentition 135 27 ToothSurfaceLoss 295
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vi Contents
28 TemporomandibularDysfunction 302 30 ManagementofFailureinthe
RestoredDentition2:Dentures 322
29 ManagementofFailureinthe
RestoredDentition1:Fixed Bibliography 329
Restorations 310 Index 333
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Contributors
RobertAdams,MSc(Lond), JohnMoran,PhD,MScD,BDS GavinJPearson,PhD,
MSurgDent,BDS(Wales), (Wales),FDSRCS(Eng) BDS(Lond),LDSRCS
FDSRCS(Eng) SeniorLecturerinPeriodontology, (Eng)
SpecialistDentalPractitioner, UniversityofBristolDental ProfessorofBiomaterialsin
Wilmslow,Cheshire School,Bristol relationtoDentistry,Queen
HonoraryLecturerinDental HonoraryConsultantin MaryWestfieldCollege,
Implantology,WalesCollegeof RestorativeDentistry,United London,U.K.
Medicine,CardiffUniversity, BristolHealthCareNHSTrust, DentalBiomaterials
Cardiff,U.K. Bristol,U.K.
Implantology Periodontology DavidKWhittaker,PhD
(Wales),BDS(Manc),
MartinAddy,PhD,MSc, AlanHarrison,TD,QHDS,PhD, FDSRCS(Eng)
BDS(Wales),FDSRCS BDS(Wales),FDSRCS(Eng) EmeritusProfessorofOral
(Eng) EmeritusProfessorofDentalCare Biology,WalesCollegeof
ProfessorofPeriodontology, fortheElderly,Universityof Medicine,CardiffUniversity,
UniversityofBristolDental BristolDentalSchool,Bristol Cardiff
School,Bristol FormerlyHonoraryConsultantin FormerlyHonoraryConsultant
HonoraryConsultantin RestorativeDentistry,United DentalSurgeon,Cardiffand
RestorativeDentistry,United BristolHealthCareNHSTrust, ValeNHSTrust,Cardiff,
BristolHealthCareNHSTrust, Bristol,U.K. U.K.
Bristol,U.K. RemovableProsthodontics OralBiologyandPathology
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viii
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Preface
This book began life in the mid-1980s when three nisable as a resin-retained bridge with wings and a
friends mused about the state of the world as they pontic but instead of being glued on, it was pinned
walkedaroundachurchyardinNorthleach,Glouces- on. There were no air turbines, no polymers; there
tershire, after a very good lunch in a restaurant were arsenic root fillings and poor local analgesics.
long since gone. The product was ‘Conservative In the early twentieth century, all the precision re-
Dentistry – an Integrated Approach’ published by tainerswewouldrecognisetodayhadbeendesigned
ChurchillLivingstonein1990.Theintentionofthat forthethenpreferred‘removablebridgework’.
book was to distil the essentials of the subject and As a student in the 1960s, I learnt the Baldwin
mergethemwiththeappropriateaspectsofthesup- techniqueofglueinginanamalgamrestorationwith
porting sciences to try to avoid the compartmental- a wet mix of zinc phosphate cement. What are the
isation of dental education and show the relation- Young Turks doing now? – glueing them in with
ships that extend from oral biology, oral pathology polymers.
anddentalbiomaterialsintoclinicalpractice. The cycle of ignorant rediscovery continues. Fifty
Theoriginalbookwasexpandedinthemid-1990s yearsagodeepcarieswasmanagedbysuperficialre-
andwaspublishedas‘RestorativeDentistry–anIn- movalandthentheplacementofatannicaciddress-
tegrated Approach’ by Butterworth–Heinemann in ingto‘harden’thedentine.Sixmonthslaterthetannic
1998. This book sold well but is now clearly past acidwasremovedandthetoothrestored.Todaywe
itssellbydate–hencethisnewedition. havethe‘new’‘stepwise’excavationofcaries.
The new book embraces the new and, I hope, re- The quest for aesthetic restorations has led to
tainstheoldwherethishasbeenseentobeclinically ‘amalgam-free’ dental practices and the prescrip-
successfulandrelevanttomodernpractice.Theprac- tion of polymeric composites for all intracoronal
ticeofdentistryhasgonethroughmanytransitionsin restorations. Milled ceramics with CAD/CAM tech-
itshistoryandthepresenttimeisnodifferent.There nologyhavearrivedtogetherwithdurableadhesives.
isthesaying‘Whatgoesaround,comesaround’and The Young Turks now reject dentine pins and post
thisappliestodentistrytoo. crowns–seeoneandglueone!Howmuchlongerwill
So,DearReader,pleaseindulgethisoldmaninthe the principles of the preparation geometry of near-
autumn of his career with a little time for reflection parallelismbetaughtforcrownretention?
onthe20yearssincehisfirstbookwaspublishedand Endosseousimplantsrepresentthebiggestdevelop-
the40yearssincehequalified. mentofthelast20years.Howlongwillitbebefore
Atripdownmemorylaneintothetextbooksand endodonticsdisappears?Crown-retainedbridgework
writings of the late Victorian era and early part of withitsuseofdubiousabutmentsisalsoacandidate
the twentieth century provides a fascinating histori- forthehistorybooks.
calperspectiveonwhatourprofessionalforefathers The practice of dentistry and indeed the teaching
thought and did. It may come as a shock to read ofdentistryisaboutmanagingtransitions–silicates
that many of the principles we expound now were to composites, copper rings to elastomers, vulcan-
expoundedthen.Bridgeworkwastaughtasneeding ite to acrylic. But there is a need to beware of false
highstandardsofconstructionwithanappreciation dawns–theself-polymerisingfillingmaterialsofthe
of the role of the occlusion and the need for sound 1950s, the sandwich technique of the 1980s, mul-
abutments. Today’s strategy for the management of tiple ‘generations’ of dentine adhesives, discarding
periodontal disease is the same as that practised in gold inlays – and dental academics have to be con-
1900thoughtheroleoftheocclusionincausingthe servative with a small ‘c’. It is no use allowing the
disease,prevalentinthe1960s,hasgone. Young Turks to take over with their revolutionary
The overriding impression is that our forefathers ideasonlytofindthat2or3yearsofstudentshave
were just as clever as us, sometimes cleverer, but qualifiednotknowingtechniquesthatturnouttobe
theywererestrictedbytheirmaterialsandequipment. stillfundamental;youcannotcallthembackandstart
LookattheBingBridgeof1868.Itisinstantlyrecog- again!